British Geriatric Society – Position on Euthanasia

first_imgBritish Geriatric Society 10 July 2015Within the British Geriatrics Society (BGS) membership, there is a range of strongly held views on this issue; however, on balance our position as a society is as follows.1.  The BGS accepts individuals’ right to determine the choice of treatment and care they receive provided they have the capacity to do so. We further accept that sometimes, some symptoms are difficult to control and that even if they are controlled people may still find their life unbearable.  However a policy which allows physicians to assist patients to die is not acceptable to us. We believe instead that the most vulnerable should be enabled  to access the services and care they need to lead as independent and symptom free a life as is possible and, when the time comes, to die in the setting of their choice with dignity.2.  Members of the BGS look after many older people with frailty, disability and those who are dying.  We accept life has a natural end and that our job is not to prolong life at all costs but to improve quality of life whilst accepting that death is inevitable. Our members have long experience of conversations with patients about ending their life.  Often these are phrased as “Can’t you just let me go?”  However our experience shows us these are more often a cry for help than a genuine desire for death.  Often, listening to our patients’ wishes, concerns and fears, and taking time to address their needs significantly diminishes their wish for death. We also believe older people may feel despair as a direct result of the reaction of others to their frailty and the care and treatment they are afforded. The BGS considers the best way for physicians to help these vulnerable people is to maximise their independence and health, rather than assisting with their expressed wish to die.3.  We know that older people are often strongly influenced by their families and carers- the vast majority, but not all, will have their well-being at heart. Even so, many requests to end life – made either directly or indirectly to us as geriatricians – come from the patients’ families and not the older person themselves. Often such requests are then forgotten if such degrading symptoms as urinary and faecal incontinence, depression and unremitting pain are relieved.4.  Much of the public demand for assisted dying seems to stem from the fear of a prolonged death with increasing disability sometimes associated with unwanted burdensome medical care.  This suffering at the end of life can be prevented by a change in the focus of care – from prolonging life to addressing the individuals own priorities and symptoms , and by the involvement of medical professionals skilled in palliative and end of life care.5.  The BGS does not accept that legalising physician assisted suicide is in the broader interests of society. We recognise that some people feel their life is unbearable; however, law makers should consider not only the rights of individuals in society but also society itself and the impact the legislation will have on all members of our communities.  The BGS is concerned with protecting the interests of vulnerable older and disabled people who already feel pressure to give up their lives to reduce the burden they feel they cause to others.6.  Campaigners for physician assisted dying argue that curing disease and bringing about death are not mutually exclusive roles, the intention in both cases being the relief of suffering. It is further argued that the primary role of the physician is to care for his/her patient, which must therefore entail respecting their autonomous wish to die. However, the BGS believes that crossing the boundary between acknowledging that death is inevitable and taking active steps to assist the patient to die changes fundamentally the role of the physician, changes the doctor-patient relationship and changes the role of medicine in society.  Once quality of life becomes the yardstick by which the value of human life is judged, the protection offered to the most vulnerable members of society is weakened.7.  The right of any individual, whether terminally ill or not, to have their symptoms controlled is undisputed. In our opinion it is crucial to distinguish in clinical practice between actions primarily intended to control symptoms and actions primarily intended to assist the patient to die.  In the same vein, the BGS would emphasise that the right of a patient to choose or decline treatment and or intervention whatever the consequences, supersedes all other guidance and wishes. This equally applies to those who express their wishes regarding their future care using an appropriately constituted advance directive who can be assured that such wishes will be respected.8.  The BGS is concerned that ‘assisted dying’, while it does not apply directly and solely to older people, will lead to a change in attitude to death in society and also within the medical profession. The prohibition on intentional killing is the cornerstone of society and it is worth preserving the notion that all lives are precious. The BGS accepts that this denies a very small number of persons the right to have their life ended by their physician if it is their autonomous wish. However it must be noted that every society puts some limits on respect for autonomy, which must be balanced against the greater good of society. The BGS urges improvement in the medical and social care of older people, placing them back in the centre of a society which respects their wisdom and experience.9.  The BGS accepts that society is changing, with a shift toward more emphasis on the rights of the individual, including the right to choose the manner and timing of their death.  If this leads in time to a change in the law to allow physician assisted suicide, the BGS will aim to play a constructive role in the discussions with law makers and officials to develop an implementation code with robust safeguards in place to mitigate as far as possible any adverse impact and to protect the interests of older people and those who are vulnerable.http://www.bgs.org.uk/index.php/specialinterest-main/ethicslaw-2/4067-position-assisted-suicidelast_img read more

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Strong families, prosperous states: Do healthy families affect the wealth of states?

first_imgAmerican Enterprise Institute 19 October 2015Poverty Studies, Society and CultureEconomics has its roots in the Greek word oikonomia, which means the “management of the household.” Yet economists across the ideological spectrum have paid little attention to the links between household family structure and the macroeconomic outcomes of nations, states, and societies. This is a major oversight because, as this report shows, shifts in marriage and family structure are important factors in states’ economic performance, including their economic growth, economic mobility, child poverty, and median family income.Strong Families, Prosperous States documents four key sets of facts about the links between families and the economic welfare of states across the country:•Higher levels of marriage, and especially higher levels of married-parent families, are strongly associated with more economic growth, more economic mobility, less child poverty, and higher median family income at the state level in the United States. When we compare states in the top quintile of married-parent families with those in the bottom quintile, we find that being in the top quintile is associated with a $1,451 higher per capita GDP, 10.5 percent greater upward income mobility for children from lower-income families, a 13.2 percent decline in the child poverty rate, and a $3,654 higher median family income. These estimates are based on models that control for a range of factors—from the educational and racial composition of a state to its tax policies and spending on education, and to unchanging characteristics of states—that might otherwise confound the family-economy link at the state level.•The share of parents in a state who are married is one of the top predictors of the economic outcomes studied in this report. In fact, this family factor is generally a stronger predictor of economic mobility, child poverty, and median family income in the American states than are the educational, racial, and age compositions of the states.•The state-level link between marriage and economic growth is stronger for younger adults (ages 25–35) than for older adults (36–59). This suggests that marriage plays a particularly important role in fostering a positive labor market orientation among young men.•Violent crime is much less common in states with larger shares of families headed by married parents, even after controlling for a range of socio-demographic factors at the state level. For instance, the violent crime rate (violent crimes per 100,000 people) sits at 343 on average for states in the top quintile of married parenthood, whereas those in the bottom quintile average a rate of 563. This is noteworthy because high crime rates lower the quality of life and real living standards and are associated with lower levels of economic growth and mobility.Given the importance of strong families for the economy, we propose four policy ideas to strengthen the economic and cultural foundations of marriage and family life in states across the country:http://www.aei.org/publication/strong-families-prosperous-states/last_img read more

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After 5 straight losses, Syracuse beats Navy in home opener

first_img Published on January 28, 2013 at 12:21 am Contact Sam: sblum@syr.edu | @SamBlum3 Syracuse finally had a match tilted in its favor. After suffering five losses to open the season, all of them on the road, the Orange returned home and managed to pull out its first win of the season.Four of Syracuse’s five previous opponents were ranked, including now-No. 4 Southern California. Against Navy on Sunday, the Orange took advantage of playing arguably its easiest opponent so far.“We’ve got to start winning some of those close matches,” SU head coach Luke Jensen said. “We’ve lost them so far early in the season. This is a good change of pace.”The Orange jumped out to a quick start by winning the doubles point to start the match. Syracuse (1-5, 0-1 Big East) swept the Midshipmen (2-3) in all three of its doubles matches to pick up the early lead. It was the first time the Orange won the doubles point all season. From there, Syracuse cruised in singles play to pick up the 6-1 win at Drumlins.Maddie Kobelt and Aleah Marrow won their match quickly 8-2.  They had only a few minutes off before they had to be back on the court for singles play.AdvertisementThis is placeholder textMarrow struggled a bit early on against Noelle Kaufmann, but battled to a 6-4 win in the first set. From there the junior raced to the win, posting a 6-0 second set.“I felt a little bit more comfortable,” said Marrow of her second set. “I went for my shots a little bit more and stayed focused for every point.”Kobelt, who was playing No. 1 singles, lost the first set 4-6. She bounced back to win the second 6-3, and then won the tie-breaker 10-6 against Emani Decquir.“In the second set I cleaned up my errors,” Kobelt said. “I really dug down and tried to work the point more and put myself on the offensive.”Sophomore Breanna Bachini, who’s had injuries plague her time at SU, took advantage of her opportunity Sunday.Bachini was the first to complete her singles match, beating Navy’s Sam Droop 6-1, 6-0.“She’s always played dinged up,” Jensen said. “She’s sometimes had to serve underhand. At one time her leg was all messed up. So she’s now finally playing injury-free. She’s a tremendous competitor. A great athlete.”Syracuse’s only loss on the day came from freshman Sophia Dzulynsky. She won the first set 6-2 against Logan Antill, but lost the second 2-6, and the third 1-6.Jensen said he was happy with the turnout for his team’s first home match of the season, even with the early 9 a.m. start time.“To see the crowd the way it is, it’s starting to become an atmosphere that we’re really proud of,” Jensen said. “Once we establish that, we can kind of build off of it.”Though Syracuse won its first match of the season, Marrow said the Orange still has a long way to go before it’s where it can win consistently. Syracuse has the chance to continue to improve at home with its next three matches at Drumlins.“It feels good (to get a win),” Marrow said. “But it’s not a relief. We still have a long ways to go. We need to improve. We got the win but we still need to do better.” Comments Facebook Twitter Google+last_img read more

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